Evaluating user experience with immersive technology in simulation-based education: A modified Delphi study with qualitative analysis.

BACKGROUND: Immersive technology is becoming more widespread in simulation-based medical education with applications that both supplement and replace traditional teaching methods. There is a lack of validated measures that capture user experience to inform of the technology utility. We aimed to establish a consensus of items and domains that different simulation experts would include in a measure for immersive technology use. METHODS: A 3-stage modified Delphi using online software was conducted to support the conceptual framework for the proposed measure. The first round was informed by prior work on immersive technology in simulation. In the first round, participants were asked to describe what we could measure in simulation-based education and technology. Thematic analysis generated key themes that were presented to the participants in the second round. Ranking of importance in round 2 was determined by mean rank scores. The final round was an online meeting for final consensus discussion and most important domains by experts were considered. RESULTS: A total of 16 simulation experts participated in the study. A consensus was reached on the ideal measure in immersive technology simulation that would be a user questionnaire and domains of interest would be: what was learnt, the degree of immersion experienced, fidelity provided, debrief, psychological safety and patient safety. No consensus was reached with the barriers that this technology introduces in education. CONCLUSIONS: There is varied opinion on what we should prioritise in measuring the experience in simulation practice. Importantly, this study identified key areas that aids our understanding on how we can measure new technology in educational settings. Synthesising these results in to a multidomain instrument requires a systematic approach to testing in future research.

Interoception and obesity: a systematic review and meta-analysis of the relationship between interoception and BMI.

BACKGROUND: Interoception refers to the processes by which we sense, interpret and integrate signals originating from within the body. Deficits in interoception have been linked to higher BMI and may contribute to weight gain. However, there have been conflicting findings and it is not clear how higher BMI is associated with different facets of interoception, such as interoceptive accuracy (the ability to detect internal signals) and sensibility (the tendency to attend to internal signals). METHODS: We conducted a systematic review and meta-analysis of studies that measured interoception and BMI. We examined relationships between interoception and BMI in children and adults separately and as a function of interoceptive facet and measure. In sensitivity analyses, we tested for evidence of publication bias and whether the results were consistent when studies with a high risk of bias were excluded. RESULTS: A total of 87 articles were eligible for inclusion. In adults (121 effects, 10,425 participants), there was cross-sectional evidence of higher BMI being associated with overall deficits in interoception (r = -0.054, 95% CI: -0.084 to -0.025) and this was consistent across sensitivity analyses. There was no statistically significant evidence of moderation by interoceptive facet or measure, although there was some variability in effect size estimates based on interoceptive facet and measures. A smaller meta-analysis limited to studies that compared participants with normal weight vs. overweight/obesity indicated poorer interoception in participants with overweight/obesity (SMD = -0.39, 95% CI -0.60 to -0.18). CONCLUSIONS: In cross-sectional studies, deficits in interoception are associated with higher BMI. However, it remains unclear whether deficits in interoception contribute to or are a consequence of weight gain and obesity.